Category Archives: Public policy
The American Public Health Association (APHA) launched its 141st annual meeting in Boston on Sunday by re-launching itself, its logo and its tagline which is now: For science. For action. For health.
”We’re deeply excited to share our new look and feel with our members and partners,” said Georges Benjamin, MD, executive director of APHA to the nearly 11,000 public health students, academics and practitioners attending the meeting. “With the challenges and opportunities presented by our rapidly changing health landscape, now is the time to better position APHA for success as the collective voice for the health of the public.”
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
Benjamin also shared the five core values that APHA’s next phase will emphasize:
- Science and evidence-based decision-making
- Health equity
- Prevention and wellness
- Real progress in improving health
Those themes were in abundance at Sunday’s opening session. ‘Social injustice is killing on a grand scale,” said Professor Sir Michael Marmot, chair of the World Health Organization’s Commission on Social Determinants of Health and Director of the International Institute for Society and Health at University College/London. At the request of the British Government, Marmot led a review of health inequalities in England, and published a report, ”Fair Society, Healthy Lives” in February 2010. He has also recently been asked by the World Health Organization to conduct a European review of health inequalities
More than 10,000 public health officials, academics and students will gather in Boston next week for the 2013 American Public Health Association Meeting in Boston. This year’s theme is “Think Global, Act Local,” drawing critical attention to the increasingly global world of health where events across the globe—from food safety, to infectious disease outbreaks, to innovative public health solutions—can impact every local neighborhood.
>>NewPublicHealth will be on the ground at the APHA Annual Meeting, with speaker and thought-leader interviews, video perspective pieces and updates from sessions, with a focus on what it takes to build a culture of health. Follow our coverage here.
Ahead of the annual meeting, NewPublicHealth spoke with Georges Benjamin MD, APHA executive director.
NewPublicHealth: Why is the theme “Think Global, Act Local” so important?
Georges Benjamin: We’re in a world in which everything is global. There are no boundaries anymore. Rapid transit through planes, the fact that our borders are so porous...public health has always been a global enterprise, but even more so today. Our food comes no longer from a single farm but from multiple farms and sometimes multiple countries, so foodborne risks for disease and illness are global. We’ve seen that terrorism disasters are global. We’ve seen that obesity, particularly with corporations that sell certain products globally, is a big issue, and tobacco has always been a global issue. So, public health is global, and the idea is that if we can learn from people around the world and then utilize those learnings within our local communities, we’ll be stronger
NPH: What are some of the meeting sessions you’d highlight?
Benjamin: Our opening session will feature Professor Sir Michael Marmot, Director of the International Institute for Society and Health and Research Professor of Epidemiology and Public Health at University College, London, who spoke at our meeting five years ago on the social determinants of health and is going to give us an update. In the closing session, we’ll hear from actor/physician/public health doctor, Evan Adams, MD, the deputy provincial health officer for British Columbia, who will speak about improving the health of native people. So in both our opening and closing sessions we’re looking globally, as well as emphasizing what happens locally. We’ll also hear from the minister of health of Taiwan, who will talk about universal health care as well as violence prevention. And we’ll also be holding sessions that track the many public crises that we’ve already had this year.
Use of tourniquets—a piece of tightly tied cloth used to keep a victim with an arm or leg wound from bleeding to death—has been discouraged over the last few decades out of concern that the method can save the life, but lose the limb. But a new article in The Wall Street Journal finds that multiple examples of successful use of tourniquets on battle fields in Iraq and Afghanistan, as well as after the bombing at the Boson Marathon earlier this year, has reopened the debate. The pros and cons of tourniquet use is on the agendas of several upcoming medical meetings and preparedness conferences.
Read the full story here.
>>Bonus Link: Read a NewPublicHealth post on new approaches to teaching more people CPR.
At the recent 2nd Annual National Heath Impact Assessment Meeting held in Washington, D.C.,Paul Anderson, MD, MPH, manager of the HIA Program at the Alaska Department of Health, spoke about his state’s HIA efforts and successes. NewPublicHealth caught up with Anderson following the meeting to ask about lessons learned that can benefit other public health officials considering and conducting health impact assessments.
NewPublicHealth: Tell us about the HIA program in Alaska and how the health department has made HIA a routine part of decision making.
Paul Anderson: HIA in Alaska started with a couple of health impact assessments done in conjunction with natural resource development permitting and environmental impact statements (EISs) in the north of the state. These studies generated increased interest in the human health concerns that arise during project permitting. The Department of Natural Resources (DNR) contacted the Alaska Division of Public Health, asking us if we could get involved with this new idea—called health impact assessment—as it related to natural resource development permitting.
After some deliberation, we realized the importance of being involved with this work, and so we developed an HIA working group. That working group met for about three years and developed an HIA Toolkit, which is our guidance document for performing HIA in Alaska. Out of that working group came a realization that Alaska needed an institutionalized HIA program in order to lead this process forward effectively. So the group eventually decided to create an HIA Program in the Division of Public Health under the Section of Epidemiology.
NPH: Have you worked collaboratively in Alaska on HIAs?
Anderson: When our program was new, we wanted to conduct field work because we needed additional health information regarding a specific region of rural Alaska. This field work involved utilizing surveys, which can be very tiring for rural communities because they are surveyed frequently. There are several agencies in Alaska that already do surveys as a routine part of their work, and one of those is the Alaska Department of Fish and Game. They go house-to-house and community-to-community and use a very well-designed survey tool to learn about subsistence foods. They worked with us to integrate some important questions about food consumption onto their survey form. This turned out to be an effective cooperative relationship that benefitted both agencies and reduced the strain on rural communities.
At the recent Place Matters conference in Washington, D.C., David Williams, PhD, the Norman Professor of Public Health at the Harvard School of Public Health and staff director of the reconvened Robert Wood Johnson Foundation Commission to Build a Healthier America, talked about the need for cooperation between the community development industry and health leaders.
“Community development and health are working side by side in the same neighborhoods and often with the same residents but often don’t know each other or coordinate efforts.”
NewPublicHealth recently asked Dr. Williams about how synergies between the two fields can help improve population health.
>>View David Williams' PowerPoint presentation from the conference:
NewPublicHealth: Is there progress on the community development and health fields working together to help improve the health of communities?
David Williams: I would say there is increasing recognition by individuals both in health and in community development that they are two groups working in many ways on the same challenges and often in the same communities and in many ways there can be there could be synergy from working together. But I would also say that this is all so new, and I don’t think the field has matured in terms of our full understanding of where the potential is. To me, one of the greatest hungers out there is for people to see examples of success and progress and initiatives that in fact have worked well together, and we’re still in the beginnings of seeing that—such as the Federal Reserve healthy communities conferences, which have raised awareness levels and have begun to help similar initiatives. But we’re still in the infancy of really capitalizing on the potential.
One of the key challenges is that this area of healthy communities is a broader issue. And that includes the need to recognize the importance of a health in all policies approach—that policies in many sectors far removed from health have health consequences. A good example is the education sector—and having teachers recognize that they are themselves are health workers in a certain sense because the work they do can have such an important impact on health.
Building on the success of the Inaugural Health Impact Assessment (HIA) meeting held in April 2012, leading HIA stakeholders including the Health Impact Project—a collaboration of the Robert Wood Johnson Foundation and the Pew Charitable Trusts—and the U.S. Centers for Disease Control and Prevention (CDC) convened the second national HIA meeting today, in Washington D.C.
>> Follow the real-time Twitter conversation about the conference with the hashtag #NatHIA13.
An HIA is a tool that helps evaluate the potential health effects of a plan, project or policy before it is built or implemented. It can provide recommendations to increase positive health outcomes and minimize adverse health outcomes. It can also bring potential public health impacts and considerations to the decision-making process for plans, projects and policies that fall outside the traditional public health arenas, such as transportation and land use.
While HIAs have been conducted for decades, their wider use has become more common in just the last few years. According to the Health Impact Project, more than 200 HIAs have been conducted in the United States on issues as diverse as transportation, economic policy and climate change.
NewPublicHealth has created a short HIA resource list with links to background information on health impact assessments.
- Health Impact Assessment posts on NewPublicHealth
- HIA Issue Brief from the Robert Wood Johnson Foundation
- HIA in the United States, a map from the Health Impact Project
- An HIA Infographic from the Health Impact Project
- CDC’s Healthy Places collection of HIA information
- CDC Resource on HIAs and Public Policy Development
- The World Health Organization HIA site
Public Health Presentations Cap First Class of Network for Public Health Law Mentorship Program for Young Attorneys
Laws and policies that impact public health can create healthier conditions for entire communities—a more cost-effective approach than treating one person at a time, and then only after they’re sick. Last week, five inaugural Visiting Attorneys in Public Health Law presented on their efforts over the past year as part of a program hosted by the Network for Public Health Law and the Robert Wood Johnson Foundation (RWJF). The attorneys focused on public health law around:
- The legality of tobacco “power walls” that put colored cigarettes boxes directly in the line of vision of children
- The impact of environmental noise on heart disease
- Displacement of residents through gentrification
- The challenges and promise of “health in all policies”
- Legal avenues toward reducing sodium intake by the public
The post-JD program is designed to help develop exceptional skills in practice-based public health law than can help lawyers to advance their public health law careers. During the program, the five attorneys were each located at a host site under the mentorship of a renowned public health legal expert. This year’s mentors included Doug Blanke, founder and director of the Public Health Law Center at the William Mitchell College of Law in Minnesota, and Clifford Rees, practice director of the western region of the Network for Public Health Law.
“This fellowship is one that we developed in conjunction with the Network for Public Health Law to help to build the field of public health law and to allow bright, new attorneys with an interest in public health, to be able to experience working in [that] setting while being mentored and coached by leaders in the field,” says Angela McGowan, JD, MPH, RWJF’s senior program officer.
McGowan says RWJF hopes this type of experience will highlight that public health law is an exciting career option, as well as show the value of engaging new professionals in this practice as a way of making meaningful impacts at the local, state and federal levels of public health. McGowan added that the Visiting Attorneys were able to really be engaged with the real work that public health and law practitioners face daily, and to apply their legal knowledge to solving public health problems.
CDC’s Ali Khan: “By Every Measure Our Nation Is Dramatically Better Prepared for Public Health Threats”
Today is the eighth anniversary of Hurricane Katrina, one of the deadliest and most expensive natural disasters in U.S. history. Close to 2,000 people died during the worst of the storm and in the flooding that followed.
Since then, local, state, national and private disaster preparedness efforts have been increasingly improved. States reeling from the impact of last year’s Super Storm Sandy on the East Coast, for example, were able to rely on some of those improvements. They included more and better trained disaster management assistance teams from other states, as well as both commercial and government social media tools that helped professionals communicate among themselves and with the public to share safety and recovery instructions.
“By every measure our nation is dramatically better prepared for public health threats than they were,” said Ali Khan, MD, MPH, Director, Office of Public Health Preparedness and Response at the U.S. Centers for Disease Control and Prevention (CDC), at a Congressional briefing last week on the topic. It was hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation. In a conversation with NewPublicHealth this week, Khan ticked off some recent advances in disaster preparedness:
Congressionally appropriated funds for the U.S. Department of Health and Human Services to allow all states to improve their public health and health care preparedness and response capabilities.
- Response activities now coordinated through state-of-the-art emergency operations center at CDC and centers at almost all state public health departments.
- Health departments use the National Incident Management System, allowing for structured collaboration across responding agencies.
- More than 150 laboratories in the United States now belong to CDC’s Laboratory Response Network and can test for biological agents with the addition of regional chemical laboratories.
- The National Disaster Medical System now includes 49 Disaster Medical Assistance Teams, ten Disaster Mortuary Response Teams and five National Veterinary Response Teams, as well as other specialized units to provide medical-response surge during disasters and emergencies through on-scene medical care, patient transport and definitive care in participating hospitals.
- The Strategic National Stockpile was authorized and expanded, ensuring the availability of key medical supplies. All states have plans to receive, distribute and dispense these assets. Development of new medical countermeasures under the Biomedical Advanced Research and Development Authority (BARDA) includes new drugs and diagnostics. BARDA has delivered nine new medical countermeasures to the Strategic National Stockpile (SNS) in the last six years.
The United Nations Foundation believes that, for the biggest public health obstacles facing the world, it will take all nations and all sectors working toward solutions to succeed. So the Foundation works to make that a reality, bringing together partnerships, growing constituencies, mobilizing resources and advocating policies that can help everyone—in both the developing and developed world.
NewPublicHealth recently spoke with Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation, about the organization’s many efforts to improve health both globally and locally—and how these two goals can support each other.
NewPublicHealth: What changes have you seen in global health during your time in the field?
Kathy Calvin: The number of nonprofits dedicated to health issues has quadrupled it seems, and real progress has been made, which is the most important point—that we’re actually seeing a reduction in maternal deaths and newborn deaths and preventable diseases such as measles and diarrhea and pneumonia. I mean, there’s just been enormous progress, with still much more to happen. But it’s been an exciting time after what I think has been a pretty discouraging period where no amounts of foreign aid seemed to be making a difference. I attribute that partly to some innovations in research and financing, but also to the fact that a lot of governments in Africa actually have prioritized women and prioritized health in some pretty significant ways. And I think we’ve had a very enlightened government in the last five years here, too, in terms of what we’re doing overseas.
So, it’s been exciting to see it. Health is not my background. I’ve really been privileged to see both how serious and significant the challenges are, but also how much good can be done with just a little bit of organized effort.
NPH: When you talk about enlightened government, what are some examples? What is making the difference now?
Calvin: Well ironically it isn’t all that political. In fact, some of the biggest shifts took place under President George W. Bush’s administration with his creation of the President’s Malaria Initiative—until then, there had been zero real depth of interest and progress on malaria—as well as PEPFAR, which some people criticized because it was so bilateral, but it had a huge impact in allowing the current administration to really set some ambitious goals for reducing and eliminating parent-to-child transmission and setting that audacious goal of an AIDS-free generation.
About 40 million U.S. workers don’t receive even a single paid sick day and millions of others can’t utilize sick leave to take care of a sick child. The result is sick kids in school—where they make others sick—and a dramatically increased likelihood of ending up in an emergency room rather than a doctor’s office.
About $1.1 billion in emergency department costs could be saved each year if every U.S. worker had access to paid sick days, according to Vicki Shabo, the Director of Work and Family Programs at the National Partnership for Women & Families. Shabo recently spoke with Grassroots Change about the importance of paid sick leave and the on-the-ground efforts to enact the essential public health initiative at the local level—while also battling government preemption efforts that would take away local ability to improve sick leave policies.
“Unfortunately, we’re seeing a trend,” she said. “It’s sobering and undeniable. There are preemption bills this year that have been introduced in 13 or so states, and several of them have passed. Last year we saw Louisiana pass preemption, and until we alerted some of the local groups on the ground, no one was paying attention to it.”
This and other examples illustrate the critical importance of grassroots efforts to combat preemption and promote improved sick leave policies, which Shabo says benefits workers and their families while having no negative economic impact. With the number of these grassroots advocates growing every day, the next step is improving training and providing more resources to improve policies statewide.
“The takeaway message is that progress is possible, it’s happening, and local grassroots activity is instrumental in the progress that’s been made. As we work federally, grassroots activity will continue to play a central role in future progress. We know that this is not something that we can do from Washington—it has to come from the ground up.”